Kate's PHT Success Story

: On today's episode, we have Kate's PHT success story. Welcome to the podcast that gives you the most up-to-date, evidence-based information on PHT rehab. My name is Brodie. I am an online physio, but I've also managed to overcome my own battle with PHT in the past. And now I've made it my mission to give you all the resources you need to overcome this condition yourself. So with that, let's dive into today's episode. Kate joins us today to talk through her PHT rehab, talk through her successes, her triumphs and setbacks, insights, revelations, all that good stuff that helps you with your PHT recovery. As you'll soon learn listening through this interview, Kate's rehab took a little bit of a different turn in terms of its direction of what might be conventional PHT rehab. So it's an interesting one that I think you're going to really enjoy and for some of you really reflect on. And hopefully. enhance the effectiveness of your PHT rehab. So I'm excited to have Kate on to share her story. Let's take it away. Thanks for joining me on the podcast, Kate. No problem. Thanks for having me. Let's dive straight in. Talk us through the onset of your symptoms. How long ago was it and when did these symptoms start emerging? So started February, 2022 and really came out, out the blue quite suddenly. I'm not an athletic person, but I keep relatively fit, but I'd basically taken on quite a long project. I spent a lot of time sitting, working. And so I kind of linked it to that, that I'd been doing a lot of sitting. It was really uncomfortable to sit. And I went to the doctor and actually they did a lumbar spine scan as a first thing. And that all came back clear. And so I carried on not really kind of knowing what, what was going on. What were you experiencing? Were you noticing like soreness, if so where to, I guess, to trigger a scan, you might've had some sort of worrying symptoms. Yeah. I mean, it was just this real pain in the right in the belly of my hamstring, um, like all leg connected. I mean, I think I had, you know, some pains in my back, some aches, but I you know, I was quite surprised that they did the lumbar spine scan as a first thing anyway. But yeah, so it was basically the sitting down pain, the sitting and the pain in my hamstring and the pain there. And when that came back clear, they recommended I do some physio, but that was literally just, you know, I got a sheet of paper from the physio, I didn't even have a conversation with them. There was no sort of guidance, 16 exercises and and just do them. It was all a bit vague really. So I just started making adjustments in my life, not sitting down quite as much. I got a standing desk. I stopped driving quite so much, but it kept going on. It kept on going throughout that year. I went to see a private physio during the summer to sort of try and actually see someone talk to somebody about it. And they had started more targeted exercises, but none of it was weight based. It was all kind of body weight still. And I just didn't really feel any benefits from it. I couldn't work out what, certainly sitting aggravated it, but I certainly wasn't seeing any improvement with the physio. So then at the end of that year, I went to see an orthopaedic surgeon. They did a leg scan. And again, they reviewed that and nothing. nothing was found. So they referred me to a sports consultant who prescribed more physio. I did a lot of clams and a lot of bridges, but it was just kind of getting worse. It was just getting worse and worse. I think what was happening was I was putting so much, I got to the point where I needed to sort this thing out and I was giving it so much attention and so much focus that I think that was creating a problem as well. I went back to the sports consultant and they decided to review the leg scan from the end of the year. And that's when they actually found bilateral tendinopathy with actually worse on the non-symptomatic side. I know that's quite common that you can get MRIs that are a bit unusual. And they also did sacroiliac joint scan and they found that had degeneration there. So they finally found some things. then recommended that I'd had shockwave. But at this point I'd been getting quite, you know, I was getting weaker and weaker because the other thing that was happening was that I was getting very fearful of it because it was getting worse. I was going downhill. I had the consultant at one point said, I probably shouldn't be doing so much walking. So I sort of stopped walking. So I was getting weaker and weaker. And yeah, just found myself in a bit of a mess really. Did the shockwave, it didn't help. and actually again made things much worse. I think I became really hypersensitive and just didn't respond to that well at all. To the point where a couple weeks later I was due to go on a family holiday in the summer and almost didn't go. It got to that point where I just thought well I can't walk through the airport, I can't sit on a plane for that long. How on earth am I going to cope with doing something like that when you know Um, how could I do that? But I did. And I think that was one of the first turning points. I, I went on that holiday and I think the sunshine, the warm pool, just calming down really helped get everything kind of back. I think it just helped my central nervous system just to relax and just realize that it's fine. You're not broken. You know, you're quite capable of walking through the airport and, you know, instead on the way back. On the way there, I'd had airport assistance. On the way back, it was fine and I got through. And that was a turning point. And it was like, okay, I need to... I just needed to sort of relax and yeah, just try and improve, improve my life generally at that point. Right. And that's, I think when we started talking. First of all, like when you saw the sports consultant before you got, and they reviewed the scans and everything, were they in agreement said it was proximal hair string tendinopathy? Yes. Yeah. So he'd reviewed the scans and agreed that, yeah, that was the thing. And as You said symptoms are getting worse and worse as they were doing more and more investigations. And were the symptoms you mentioned like initially was sort of mid hamstring soreness with sitting. Did any of those symptoms change? Like did the location of the symptoms change or become more widespread or the sensation become different at all? Yeah. So it always traditionally been sort of bellied hamstring and then at the top, the sort of the insertion area. But it did move around at times. And again, I couldn't understand why that would happen. Where did it move to? Sometimes like the lower part of my hamstring, sometimes just anywhere around that leg area and kind of, yeah, just on my sit bone. It did shift. It did shift around a bit. Okay. Yeah. Good to know. Um, then we jumped on calls and we started working together and we agreed let's treat it like it's PhD and see what happens. And, um, we went through, you know, traditional PhD activation exercises route. Uh, how did all that, what did that, how effective was that approach? Do you think? It was because I think it, it was making me stronger. Like that. was such a benefit, right, you know, being stronger is obviously going to be more beneficial. It was a really slow process, wasn't it? Like we were going very slowly so that I didn't freak out, I think, and start thinking I was going to have done too much and had a flare up. So yeah, I definitely felt at times I was making good progress and then I'd have a bit of a setback. So it wasn't and It wasn't straightforward, I don't think, was it? And then do you remember at one point, you made the comment that we were putting out fires, because if it wasn't my leg that was hurting, then I had some back pain. And then, you know, I started having foot pain, plantar fasciitis. And there were all these things that if my leg was feeling okay, something else was kind of flaring up as well. And yeah, it felt like we were trying to... to do lots of things, but generally I was making, I was still in a much better place than I was in that summer. So that was good and I was getting stronger. And yeah, I do remember, um, the, like one of the initial things we were working towards was just walking, just like walking distance and, you know, walking kids to school, like those sorts of things that were very meaningful for you. Uh, and the building up that tolerance is like, okay, this is like, usually with PHT, usually walking distance is okay. Like if you can walk slow, you can usually do so without much irritation. But going, hearing your story and seeing how much deconditioning had been done, there was sort of like the agreeance of, well, let's try like PHT, but if it's not making the symptoms better, at least we're getting you stronger. At least we're building up your capacity to walk and function. do day-to-day things and get something that's a bit more meaningful back into your life. Because as soon as you start taking things out, yes, it starts with sitting. So yeah, I can stand at a desk at work. That's fine. But then as soon as you start limiting your driving, well, you're sort of sort of limiting some sort of day-to-day things. Then it becomes more and more meaningful as well. Now I can't walk my kids to school. Now I'm second guessing going on holidays. Now I'm like, and it's really starting to. impact life more and more. It's like, all right, now priority number one is just trying to restore some function and get some, some of your life back on track. Um, but you said somewhat effective, very slow going. Yes, we did start our exercises very easily progressing very gradually. Um, how effective do you think it was? Uh, how much could you return to, um, before we started mind body stuff. Um, it fluctuated, didn't it? Because there, there were times that I'd be able to sit for 50, 45 minutes. And, and that would be fine. There were times when I could sit for an hour and then there'd be other times that I'd be struggling at 10 minutes. So yes, I was strengthening and I could fit, I could feel everything sort of getting more, getting stronger, but it didn't necessarily correlate with. my ability to sit, which was obviously always the hardest thing. My walking was quite a quick thing to sort of claim back, if you like. But I think the feeling, like you say, when you start losing all that stuff in your life, where you're not going out and you're feeling isolated, because you can't see friends and you can't go and do this and you start worrying about the future, how am I going to do this? How am I going to... take my children to school. It's so impactful on how it just makes things so much worse, isn't it? Definitely. Yes. Can you recall how long you had have had PhD symptoms or how long we were working together before the initial like introduction of some sort of psychosocial influence going on that's impacting your pain and sensitivity? So we start, I think we started properly in December last year. So I think we did, and then we had that turning point in May, June. So it was six months. We'd had, I think we'd had a couple of calls before that, but then we, you know, we did, we did a solid sort of six months. So, so yeah, so we'll sort of, we were sort of having some prior discussions about, well, some of this isn't making a lot of sense mechanically. Um, and started, I guess, entertaining the possibility of some of these symptoms being, um, or the, the pain sensitivity being triggered by some sort of psychosocial influences and those sorts of things, um, from your memory, uh, what was your like first introduction to this? Like, what was the first resource or book you read or something that really resonated with you to say that there might've been something else going on? So I read. the John Sarno books last summer. So that was the summer when I was like right in that sort of low bit. And I thought it was really interesting, the idea of TMS. And I believe that was a possibility, but it didn't resonate for me particularly, because it seemed to focus a lot on the emotions being sort of anger and trauma and grief. major emotions. And I thought, well, I'm not really going through anything like that. So I certainly didn't apply that to myself. But I think I've always kind of had an understanding and a belief in my body. I think I always knew that you had to feel good in yourself to feel, you have to feel mentally positive for your body to feel positive. So I kind of had made that link. So I started doing a few things in my life to try and help. improve my situation. So things like, you know, feeling isolated, I joined a choir and, you know, I did some volunteering, like all trying to find things that I could manage that wasn't too far to drive. And just the things that, you know, I work from home, so it's quite isolating. So just being part of a community again. So I knew that there was this link, but I'd never... taken it so far as to believe that in myself, that your emotions could actually be impacting your pain, not causing your pain. I think I believe that it could impact them, but not actually be the root cause of it. And what changed was when I read that David Schifster book. Is that, yeah, I don't know how you pronounce his surname. Yeah. So the book, Think Away Your Pain, you said that, so you've, you read the sano books, you were introduced to this thing called TMS, which is tension myositis syndrome, and essentially just means tension, producing, you know, muscle or mechanical pain, predominantly brought on by previous histories of traumas, or, you know, some deep seated emotions that just held. the history of your deep seed emotions is held within your nervous system that can manifest as pain if it's ever, you know, if that ever emerges. But you're saying that didn't really resonate because the history you're looking back in your life and looking back, you don't feel like you're holding onto any past traumas or conflict or anything like that, is that fair to say? Yeah, exactly. Yeah, exactly that. Okay. And so what resonated with the Think Away Your Pain book that Were there any parts of that sort of just started to increase this belief? Yeah, it was almost like a lark's egg turning on when I read this book, because there were so many things that I just saw in myself, things like, you know, MRIs being inconsistent, pain levels being higher than what you'd expect for what you've got. It seemed to broaden it out. It didn't. talk more about just general emotions like stress, anxiety, and fear. And I think fear was a massive one for me. I think I was so fearful of having a flare up, of setting myself back, you know, Oh my goodness, you know, I'm going to lose all that strength because I've got this flare up. You know, I'm going to say, go back months and months and not being able to build it up again. And consultants telling you, you shouldn't be walking that far. So you stop walking. That there's such a lot of fear around it. That I think that that. And then the fear of losing the life that you want to be living, you're not being able to get out and do the things, you're cutting back on work because you can't sit down at your desk. And this thing really triggers so many emotions, like your stress and your anxiety about these problems, and then this big thing about fear. And I think the book really talked to me. around those issues. It doesn't have to be something that's deep seated in your past or one of those bigger emotions, I think your day to day stresses and emotions can really impact it as well. Yeah. Would you, prior to this pain, prior to all of this, would you consider yourself a stressful person? Would you consider yourself an anxious person? Really? No. Not really. I think I'm a person that likes to have everything right. And so I work hard to get things together. And perhaps that makes me, you know, I've not, I've not had mental health issues before. I've not had anything like that. I don't think I'm particularly stressy or anxious and never had anxiety like, you know, in that kind of way before. So I think that really surprised me that suddenly I feel like I'm dealing with a mental health condition rather than actually a physical condition. But then that was almost a lightning bolt as well, because it's like, physically, your body is absolutely fine. And you can do all these things that you've been restricting yourself from doing out of fear, because it's actually all in your head and you can control that and actually... You can, you can sit down and you can do that. And you can go on a plane, you can go and sit in a car and you can drive two and a half hours. You're just telling yourself that you can't be fearful of doing it. So you're not doing it. And then you're in this circle of not doing it out of fear. It's, you know, talking, like hearing your history from like the onset of symptoms. A lot of people can convince themselves that this isn't me because my scans show PhD, like I went running one day and I felt a strain in my hamstring, or in your case, I was sitting for a long period of time. So that's what caused it. It's not my mind that manifested it. It was me actually sitting for that long that caused it. So they can instantly dismiss this particular theory. But all the other things that after the fact of these onset of symptoms, like some people can have hamstring pain for sitting for long periods of time and then the next week it's gone. But for whatever reason over the weeks and months of you developing this, it was quickly associated with a lot of fear. Well, I say quickly, but you know, it would have been slowly over months, like fear that got brought on, more scans, more doctor's appointments, more fear, more anxiety, more worry about the future. But then as we talked about before that. stripping back more and more of your identity, more and more meaningful things in your life, which trigger more fear, which trigger more pain, which trigger more uncertainty, and that just perpetuates over months and months and months. No doubt that emotion, fears, anxieties are going to become a part of this rehab. And so would be very ineffective or very limiting in terms of rehab, if we were to just do the strength training, if we were to just progress things with you constantly being in fear and worry and fear about the future as you described. Um, and so I just wanted to highlight that point because there'll be a lot of people listening to this and it's like, yeah, but like, that's not me because I was doing sprints and felt my hamstring twinge and then that's what caused it. So it can't be from my. my mind. Yeah. And I think that is interesting because the pain, it is a physical, it's a structural physical pain. It didn't feel like it's any different from any other type of pain, if you see what I mean. Yeah, it feels like you have got an injury. There's no difference in the type of pain, whether it's coming from a place of emotions or stress or whatever it is. Yeah, it's... it's really hard to apply it to yourself because you think, how can it possibly when I've got the proof of this? And that was one of the first things I did actually after reading this book was just, I had to go and write down all the evidence that told me that this was more of a mental issue rather than a physical one. So I went back through thinking about when I'd had flare ups and what was perhaps going on in my life at that point. Things like... It just, the very fact that I was so much stronger at that point than I had been in probably the last 10 years and yet I couldn't sit down for like half an hour. I mean, it just didn't really make much sense. Um, so yes, I, I remember I just wrote down all this stuff, which I will still go back to if I'm having a bit of a doubty day, you know, just saying no, you know, it's absolutely here, look at it, it's all here. Yeah. I like that. And that's what I'm constantly doing when I, you know, Meet with clients week by week and get more and more learn more and more of them as a person. And I have my own little buckets to be like, okay, how much do I think makes mechanical sense? How much do I think is more emotional, emotionally driven or, and because all pain, like you could fracture your arm and there will be influence, like emotional influences that heighten or dampen that pain. And so. You know, it's not just as simple as is this in your head or not? There, there'll be like, you know, certain percentages and that's what I'm constantly playing at. How much is this making mechanical sense in terms of, okay, when I sit for this period of time, even if I'm not thinking about it, this is the pain I get. Or if I increase my running from 5k to 7k, this is my, um, increase in pain and like everything that makes that sort of sense, but then we look at the other bucket and I just constantly just gather data and listening to you saying like. You know, I became more and more fearful of traveling and I had to, I was in so much pain that I had to get airport assistance to the flight. But then once I was traveling, I relaxed, you know, I, everything was okay. And then afterwards, after just relaxing, traveling for a certain bit of time, I was okay at the airport afterwards. And so that doesn't make mechanical sense. Um, you might find days where you are more. emotional, more stressed, more worried, it might be something to do with work or family and that might increase your pain as well. But then another thing that I look at is, when someone has a flare up, well, what's caused the flare up? If it's something really, really minuscule that leads to a seven day flare up, well, that doesn't really make sense in terms of what we would expect the nervous system to do or like the pain system. Sure, if you made a little I think that's a good point. I think that link towards more of an emotional connection. And so I want to keep constantly reminding myself of that. Because that was one of the, at the point that you first mentioned that book, I was in the middle of that big flare up where I hadn't experienced anything quite like this. It was pain in my feet, pain in my back, pain in my legs, everything hurt, like lying down, standing up, and then so despairing that what, you know, this is ridiculous. I can't sit down, but now I can't lie down and I can't walk and I can't stand. Like, how can I be in this? And I remember waking up and I'd have pins and needles in my arm. And I remember we had this conversation and you just said, this is not just a normal, you know, this is your central nervous system, you need to calm things down to get back on track and, and then, and that, that did really help because then it's just like, no, you just take one day at a time and you will do that walk to school and it doesn't matter if you don't. don't get there on time, you go slowly. You know, it's just stop worrying about it and just take it slow. And then you realize you can do it. It gives you the confidence that you can do it. And you don't have to rush to the gym. You don't have to rush and get, do deadlifts to get better. And I remember, I remember saying that to you that by the end of that week, I'd kind of, it all started to calm down again. And it was this relief of knowing that. I can just do it just by taking my time and just not worrying about it. And, you know, the gym will be there next week when I'm feeling stronger to do it. You know, and yeah, that worry about, oh, well, I'll lose, you know, how long is this flare up going to take then? And that was at that point that you said, I think you should read, you know, recommended the book because you said to me that this is definitely central nervous system. And I think somebody actually saying that to me that It isn't your tendinopathy. This is a central nervous issue. And reading that book and combined with that, and then going back through history in terms of emotional history and feelings just made such, you know, yeah, made a huge difference. I want to talk about your, your interventions straight away. Like when you started doing things, what were the initial interventions that you found effective? First thing that I started doing was when I felt my symptoms, instead of automatically thinking, what have I done? Like, have I sat too long? Have I been in the car too long? I'd automatically think, how am I feeling? Like, how's my body feeling right now? And it would often feel tense. I'd realize that I'd be taking quite shallow breaths. So I would just like try and just, okay, calm down and do that every single time. I felt anything. automatically just, it had to become a habit that I think emotionally, I think about your body, not about what I'd physically done to make that happen. It was more of a, you know, how is your body feeling? And I think that was, that was one of the big things that helped. Yeah, as I said, did the evidence looked at what was going on when I had a flare up? I did the journaling. uh, like writing down, wow, how you're feeling that day. And that was really interesting because I'd sit down at night and I'd start, and I get into bed, feel a bit sore and achy, start writing. And I could literally feel things relaxing and just, yeah, as you start writing down the things that stressed you out and, um, how you're feeling that day. I also tried the, um, talking to your pain one. which, uh, you know, some people say is a good one. And I, you know, I think for me, it's more of a reassurance. Like, so for example, when I did like the first car journey for a long time, it's just kind of reassuring myself, you know, all these aches and pains, it's just. Sorts of feelings that anyone would be feeling if you'd been sat in the car for an hour and a half, it's fine. You know, calm down. The tension that you're reporting is like, okay. Intervention number one, just like trying to consciously relax, remind yourself to relax, just whether that's, you know, deep breathing exercises or just physically like tuning into your body. How am I feeling? Am I tense anywhere? Let me just like chill out. But like I said, the journaling of, I don't know, self reflecting on your emotions, how am I feeling that day also allowed you to relax a little bit more and pay attention to that. Because we're not only talking about maybe physical tension that your body is like, you know, wound up and really tense, you need to unwind. But I think the like hormones that circulate throughout your body, stress hormones that circulate throughout your body are very much pain amplifiers, and telling yourself to unwind and relax and just chill actually calms down those hormones that circulate throughout your body that actually dampen pain. You mentioned that things were turned around quickly. When did you start seeing improvements after implementing these interventions? How quick was it? How effective was it? Literally straight away. I started because I think I knew the evidence was there, I got to the point where I could see that this wasn't a physical thing anymore. And so I just knew, you know, that flare up that had all been central nervous system symptoms. was just proof in itself that this was more, there's more stuff going on than just a structural tendinopathy thing. So I knew in my head that my body was capable of all the things I'd been stopping doing. So, you know, for example, I stopped sitting on the cushion straight away and I stopped, I sat and had my lunch on the grass one day, which I hadn't, you know, down a hard floor, which I wouldn't have done in like 18 months or something. But straight away started to do this. And I did do it fairly gradually, but did start changing things straight away and saw improvements literally straight away. It was, I can't tell you what a sort of light bulb moment or felt like I was suddenly getting my life back because I knew that... it was fine that there wasn't anything structurally wrong. And it was just something that I just needed to work through and become more confident and more clear in my own head. One of the reassurances I have for people, sometimes it's reassuring, sometimes it isn't. But like when we sort of make this connection about how much is really emotionally tied to this pain experience. You know, some people think Oh, well, if it's all in my head, then that's harder. I'd rather just do my deadlifts. I'd rather just, you know, progress my deadlifts and get strong and see those tangible improvements. Um, for some people it's very hard to comprehend or even believe or, you know, buy into, but the reassurances I like to say to people is, Hey, we can calm down your central nervous system in five minutes, just with the right techniques and breathing exercises and, you know, just being in tune with your body. Um, And just like your experience, you can get significantly better in the course of like a week or two, rather than waiting months and months to build up this strength. It's actually a very insightful. And I think anyone who is listening to this, even if 90% of their pain is resembling a mechanical sort of pain, there's always going to be some percentage that is emotionally tied. And I think this conversation might help. I don't, how people self-reflect on how they think about their pain, how often they think about their pain. Do they worry about the future? Are they frustrated about the past? Are they fixated on scans and doctors? Are they frustrated with doctors with a misdiagnosis or just pushing them around, not feeling heard, not feeling understood. And you know, what does that mean for your family? Do your family understand, is there frustrations there with pain and function? And how is, is this stripping away your lifestyle? And. that sort of thing. If anyone can sort of resonate with these links that sort of manifest psychosocially, then yes, let's start addressing that even if it's 10% of your pain presentation, that 10% can be a significant factor if you just work on the psychosocial elements of recovery. And, you know, there'll be a lot of people listening that is that are in your situation that you were in. and can start doing these things and start seeing the same benefits and as quickly as you might've experienced as well. I think the attention thing is really important as well, because I think, I think I focused so much on this and really was trying to fix it. So everything, everything was, everything, it became part of my life. You know, it took it, took it over really, because I was just trying to. solve it every morning, I'd wake up and like, what are my symptoms like today? And I think part of, for some people tracking their symptoms works really well. But I think for me, it wasn't a positive thing for me, I think, because it made me focus on it even more and think about it all the time. And, you know, am I a three today or am I a five or am I only a one today? You know, it just made it constantly. at the front of my mind and that was not a healthy thing for me either. So that's just, that's just useful for people to bear in mind, I guess, if some people it does work, but for other people, perhaps that focus, yeah, can be a bit too much. Are there any other interventions that you came across that you have found helpful in the months of you exploring this mind body stuff or have you just stuck to what's worked initially and sort of doubled down on that? Yeah. To be honest, for the first month I did the journaling and thinking about how I'm feeling when I had symptoms and things and the reassurance that it's fine, it's normal, I kind of ate some pains, that kind of thing. But because it all improved so quickly, I've not really had to do much more than that really. I think it was just, I just became so much more aware that this, yeah, that I was kind of back to normal. So I carried on as I would have done sort of 18 months ago. Yeah, I think I really enjoy swimming. I think swimming is a good one for me actually, because I find it quite meditative. And I think it's those sorts of things that calm your central nervous system, whatever that might be, whether it is meditation or... I don't know, yoga or whatever it is that you might find calming. Um, that's been good. I think the buy-in is really important with these sort of things. So like changing your belief system about pain and changing your belief system about your recovery is really important. You kind of, you can't continue with this rehab thinking that like, okay, let me just do some journaling, but I don't actually believe it. I don't actually think this is emotional tied to my pain, but like, let me just do it anyway. Cause Brody and Kate say I should, so let me just go. I think the buy-in is really important. The belief is really important. But the fact that you sort of start exploring these ideas, it started resonating with you and then you started seeing results, that is a buy-in in itself. The fact that you can get so much better in the, in the space of days is profound. And, you know, illuminating about how much this was actually linked in. And so then you doubled down again. It's like, okay, well, this is obviously. emotionally tied because if it was a tear in my hamstring or if this was like damage in my lower back, or if this was a tendinopathy, they don't get better in a few days. Um, and so then you double down, double down, double down. So I think the fact that you've had so much effectiveness as well as how quick it has been has also, you know, helped the buy in process. Um, and so, yeah, I, I want to sort of get an update here as to where you are. at the moment, currently, functionally, symptoms like where do you find yourself today? I mean, I can't believe where I am, but compared to a few months ago, I just wouldn't, of course, it would be possible. You know, I drove, bearing in mind that I was only driving 10 minutes down the road, and then, you know, that was the most that I could do. I drove two and a half hours the other day, which was amazing. And just, yeah, sitting down and working normally so I can take on more projects now. So I'm finding it a bit more stimulating, you know, just getting my life back to normal. I can go out with my friends and have dinner and I don't have to go and stand up in the middle of the restaurant. You know, it's normal things that for such a long time, I had to compromise on really. So. Yeah, that's good. Yeah. And I've been going back to, um, I did a robots class again, so it felt really good going back to do something that was a bit more high impact again. Um, yeah, I've, I've have done it. I mean, it sounds like it's really, it's really quick, but I've also, I didn't want to go and do that two and a half hour drive in the, you know, in the third week of realizing that I was kind of better, like I have kind of broken myself in a little bit gently, but it happens so quickly and like you say, so dramatically that you literally can't believe it. Any symptoms? Any like pain, tightness, soreness, pins and needles, anything that's going on at this stage? I still get a little bit of, you know, tightness. Interestingly, when I was preparing for this call, I think because I was remembering some of the symptoms, I could feel them again. So I thought that was quite interesting that, you know, that pain, the memory of your pain is always still there. And I think coming back and thinking about all the things that happened, I could feel it coming on again. I was like, no, don't hope. This is just, you know, you've not done anything too much. You're not physically done anything. You're just thinking about that pain. And that's why it's... resonating for you. But I do. So that's why I like to go back and think about that evidence. Because I do think it's still something that I have to drill into myself sometimes, you know, not all the time. But sometimes, you know, if I've got a lot on and a deadline or the kids or whatever, whatever it is that might be causing me stresses like, no, calm down. Those symptoms might be coming up. Yeah, it's, it's only, you just need to calm yourself down. And so yeah, read the evidence, think about how you're feeling. Yeah. I think that's really well said. I think, um, the, the whole calming yourself down and like, even just like the fascinating thing of you, like having some pain, thinking about preparing for this call and trying to sort of recall what has happened and, um, reliving, I guess, the whole, um, pain and sensations and that sort of stuff. It's makes sense how that stuff would for emanate. I remember I talked about in the podcast a long time ago, but I used to have this shoulder pain, which was, I would say, looking back on it now, probably like 80% mechanical in terms of like, if I was to reach it, it would pinch and then it'd get irritated if I was to like get dressed. And, um, it initially got brought on by playing basketball and reaching for a basketball and like pulling my shoulder back and then that really irritated. And so that was months and months of me having this. what was a long head of biceps tendinopathy. And I remember just one day driving the car hadn't played basketball for months, shoulder felt better. And I just got a text message from my friend saying, Hey, we need someone to fill in for basketball. Can you play? And I was going to like, I was obviously going to say, no, I wasn't really ready to play and I didn't think I had the time. But the fact of me reading that text message, thinking about me playing basketball, just driving my car, not moving or anything, I started to get shoulder pain again, and it was just like reliving. I don't know what it was about it, but it was just, oh yeah, I used to have shoulder pain, that's why I'm not playing basketball. And then just thinking about it, just like it was brought to my attention. And then that started to manifest and like calming myself down, that's the stuff that went away again. But just that one experience was like, hmm, that's really interesting. And now years later, that was probably 15 years ago, but like now that I understand so much more about pain, makes complete sense and hence like your experience writing down, preparing for this podcast. almost is, well, is another data point in that bucket that I sort of, you know, start calculating that sort of thing of why this is so emotionally attached. Yeah, I need to write it in my book, it's more evident. Are there any other final takeaways, Kate? If someone is struggling with their rehab, if someone is in a lot of pain, if what they're listening to today is really resonating with them, do you have any advice that we haven't yet discussed that might be some good final takeaways? We've probably touched on it a bit, but I mean, yeah, for me, I think I always knew that emotions impacted pain, but I think it was that step of suddenly realizing, no, your emotions are actually causing your pain. That was quite a big turning point. I think that's really good. I think your tips on the emotional sensations, because some people can say, okay, your emotions ramp up your pain sensitivity. But there needs to be pain sensitivity there to start with. But what you've sort of realized is no, the actual emotions can manifest the pain and start the pain trigger as well. It doesn't necessarily have to have a physical origin. It can be an emotional origin to trigger that pain. And that's probably why you've had such success so quickly, straight away, as soon as you started talking about the emotions. And I think you've laid out some real practical Takeaways, the journaling, the calming yourself down, the gathering data to, you know, sort of reinforce how much of this is tied into the emotional side of things. I think there's a lot of people that will listen today and like make links to a lot of their things of how they think about their emotions and how they think about their injury, how they think about the future, how they worry about the past and those sorts of things and come up with some strategies to help make that experience better. So. All in all, it's been a great journey. I know you, when we were talking about the podcast, she's like, Oh, I might not be ready. Let me work for a few more months and see how things go for the few more months and see how things are. But I think where you've found yourself today has been absolutely fantastic and a great story to share a lot of insights for a lot of people. So thanks for coming on and sharing. No worries. Thank you. Thank you very much. If you are looking for more PhD resources, then check out my website link in the show notes. There you will find my free PHT 5-day course, other online content and ways you can personally connect with me, including a free 20-minute injury chat to discuss your current rehab and any tweaks you might need to make. Well done for taking an active role in your rehab by listening to content like this, and together we can start ticking off all of your rehab goals and finally overcome your PHT.